Hating Charge

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Being in charge is probably good for me, right? It keeps me aware of what’s going on, teaches me to delegate, helps me understand how a unit runs smoothly, and forces me to problem solve. But I think I hate it. And I’m not alone: many of my co-workers have opted out of charging my unit. Now I know why! Every night I dread going in only to find out I’m in charge (which I am most every shift I work).

I feel like charge takes away from my own patient care–because at my hospital, charge nurses need to take a patient assignment. I miss the model I’ve worked in before where the charge nurse is patient-free and can concentrate on being more of a resource to the other nurses, a critical thinker when it comes to working out unit problems, and available to doctors and management for the whole backing-up-your-fellow-nurses role. Plus at about 24 bucks for the shift, charge doesn’t pay that well as an incentive.

I know that charge “advances our skills,” but sometimes I just want to hunker down, give good one-on-one care and not worry about everyone else and the unit at large. *sigh* I’m reluctant to bail because then who would do it? That’s not the best reason, I know.

Anyone out there love charge? Advice?

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Amy Bozeman

Amy is many things: a blogger, a nurse, a wife, a mom, a childbirth educator. She started her journey towards a career in nursing when she got pregnant with her first child. After nursing school and studying "like she has never studied before" she entered the nursing profession eager to get her feet wet. The first years provided her with much exposure to sadness, joy and other complex human emotions. She feels that blogging is a wonderful outlet and a way for nurse bloggers to further build their community. Traditionally, midwives have handed down their skill set from midwife to apprentice midwife. She believes nurses have this same opportunity: to pass from nurse to new nurse the rich traditions of this profession.

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3 Responses to Hating Charge

  1. Granny RN RN

    Being ‘in Charge’ is an unenviable position-nothing glamorous about it at all.
    However, keep in mind that you would not be there if you were not the MOST capable person to do it on a given shift. And that can TRULY suck!
    I have had times when the rug was literally yanked from under me just AFTER I had taken report and could not leave without being charged with Abandonment before the State Board. Being stuck with THAT kind of a 12 Hour shift to look forward to will make you believe in a Higher Power whether you think that you want to or not.
    The absolute WORST was just after report for a 7A-7P shift (in a MAGNET hospital, no less) when I had a full unit of 9 Neurosurgical and Med-Surg ‘overflow’ patients; with 3 on vents, 4 on vasoactive ‘drips’, 2 preop and 3 more postops expected before night shift.
    The Staff? Myself (in Charge), One other Critical Care RN, 2 ‘floor’ nurses who ‘could not take vents or do drips’, 1 new graduate nurse who was on orientation and not yet licensed, 1 patient care tech and 1 secretary.
    Just after report, when the night crew had left, I received a call from the House Supervisor informing me that she was ‘pulling’ the other Critical Care RN to the ED because ‘they have people on drips’. I protested STRONGLY to her AND to the Vice President of Nursing that MY patients were also ‘on drips’ and were no less in need of at least TWO nurses who were similarly skilled for the day. I was told that the move WOULD be made and that I must ‘do the best that I could’ with what I had. NO choice, NO help.
    Needless to say, I felt completely ALONE that day and did NOT hesitate to let my surgeons know what their patients were to be left with for ‘Intensive’ caregivers. Even my unit Medical Director went to bat with administration to no avail. Just got all the right people ‘pissed’ at ME.
    I managed to ‘get through’ the shift by the grace of God and with the help of my experienced Secretary and PCT. The new grad. did her best but I still had to supervise everything that she did. Nobody died or deteriorated and I never ate anything for 13 hours. Nobody who showed up at 7p could believe what had happened.
    I went home shaking and exhausted. Practically curled up in a fetal position at home. Don’t know how I got through the next few days but a ‘lifeline’ was thrown when my regular MD prescribed a mild sedative and hooked me up with a private ‘shrink’ to debrief with.
    The Aftermath: none of the supervisors or other nursing administrators so much as said a word about how my people kept the unit afloat that day. No thanks, No apologies.
    Only the doctors knew what I had managed to do as Team Leader that day and even they could not believe the mess that I was left with.
    I threw the damned Magnet pin in the garbage where it belonged.

  2. grammpaa

    I don’t know about other states but here in Texas I would call safe harbor and you can bet my manager and director would have their butts in the unit.

  3. scrubdoogie RN

    I really enjoy being in Charge of our unit, but our unit consist of 4 O.R.’s and outpatient rooms, and 4 PACU bays. We are a small out patient surgery center. Also, I am only in Charge in the afternoons and/or when my DON and the regular RN is abscent. It does build up my skills, I have 22 years of OR expience with 20 of them as a surgical scrub (2 as an RN). It can be very demanding at times, and sometimes I can not please everyone with decisions I have to make.